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Research article

Rheumatoid cachexia is associated with dyslipidemia and low levels of atheroprotective natural antibodies against phosphorylcholine but not with dietary fat in patients with rheumatoid arthritis: a cross-sectional study

Abstract

Introduction

Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular
disease (CVD) independent of traditional risk factors. The aim of this study was to
analyze the associations between diet, body composition, lipids and atheroprotective
natural antibodies against phosphorylcholine (anti-PC) in patients with RA.

Results

The mean body mass index for the women and men was 25.0 and 27.0, respectively. Central
obesity was found in 57% of the women (waist circumference >80 cm) and in 89% of the
men (waist circumference >94 cm). In all, 18% of the women and 26% of the men had
rheumatoid cachexia. These patients had significantly higher total cholesterol (P < 0.033), LDL (P < 0.029), and trendwise oxLDL (P = 0.056) as well as lower anti-PC IgM (P = 0.040), higher frequency of hypertension (69%) and metabolic syndrome (25%) than
those without. The patients reported a high dietary intake of saturated fat, which
partly correlated with fatty acid composition in adipose tissue and significantly
with disease activity. However, patients with or without cachexia did not differ with
respect to dietary fat intake or intake of Mediterranean-like diet. Additionally,
patients on a Mediterranean-like diet had high levels of anti-PC (P < 0.001).

Conclusions

About one in five patients with low-active RA displayed rheumatoid cachexia. This
condition was associated with high levels of LDL cholesterol, low levels of atheroprotective
anti-PC and high frequency of hypertension, which is of interest in the context of
CVD in RA. The cachexia could not be related to diet fat intake. However, patients
on a Mediterranean-like diet had high anti-PC levels in spite of similar frequency
of cachexia. High anti-PC levels may provide some protection against CVD.